| NPI | 1346223872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MN 50724) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MN 50724) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IA 23699) | |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2024-02-13 |